The High-risk and Population Strategy for Occupational Health Promotion (HIPOP-OHP) study: study design and cardiovascular risk factors at the baseline survey

Abstract

In order to establish the methodology of a population strategy for improving cardiovascular risk factors, we have planned the High-risk and Population Strategy for Occupational Health Promotion Study (HIPOP-OHP study). This study is a nonrandomized control trial in approximately 6500 participants in six intervention and six control companies. Our population strategy is based on three factors, nutrition, physical activity, and smoking. For each factor, a researcher's working team was organized and has been supporting the intervention. A standardized method to obtain comparable data has also been established. In the baseline survey, urinary sodium excretion in male subjects was higher, and urinary potassium excretion was lower in both genders in the intervention group compared to the control group. The prevalence of hypertension for both genders was also higher in the intervention group. Male subjects in the intervention group had higher serum total cholesterol than controls, while high-density lipoprotein cholesterol was lower in both genders in the intervention group compared to the control group. These differences were reflected by our finding that the predicted relative risk of coronary heart disease for male subjects was significantly higher in the intervention group (relative risk, RR: 1.17; 95% confidence interval, 95% CI.: 1.09, 1.25) and significantly lower in the control group (RR: 0.93; 95% CI.: 0.89, 0.98) compared to a model Japanese population. Similar results were observed in the female subjects. Taken together, these findings indicate that it is possible to compare trends of predicted relative risk for coronary heart disease between two groups. Keywords: population strategy; high-risk strategy; blood pressure; cholesterol; smoking; intervention IntroductionLifestyle modification is an important method for controlling cardiovascular disease risk factors. Many studies have shown that intervention programs combined with health education result in clear improvement in these risk factors.1-10 However, the majority of these studies incorporated high-risk strategies such as comprehensive intervention following risk factor screening of the study population. While high-risk strategy can be readily understood and strongly motivates subjects to change their behavior, it may not have a marked influence on subjects with low latent risk. As a result, these strategies may not significantly reduce overall www.nature.com/jhh cardiovascular risk in the population. In order to effectively reduce a specific disease in a population, it is useful to shift the distribution of its risk factors towards the low-risk side, even if this shift is minimal.11,12 For example, Stamler et al 13 found that a mean reduction in systolic blood pressure (SBP) of 2.2 mmHg in middle-aged subjects was associated with a 4% reduction in the risk of coronary death and a 6% lower risk of stroke death. These findings demonstrate that population-based strategy, involving intervention in a large number of low-risk subjects, is effective for redu...

Association between Visual Message and Health Knowledge in a 4‐month Follow‐up Study at Worksites

“…Worksite cafeterias and stairs in multistoried office buildings provide options for health-related behaviors 4,5) . Fitness facilities and walk paths may exhibit employer policy about health behaviors through environmental strategies 21) .…”

“…The workers who recalled the posters and flyers had more correct answers on knowledge questions than those who did not recall the posters or flyers (p<0.01). In multivariate analyses, seeing the visual messages was associated with a positive change in response to physical activity questions (odds ratio=1.49-2.03), and the number of m e d i a r e c a l l e d w a s a l s o s i g n i f i c a n t Most health promotion trials at worksites follow a multicomponent intervention approach [1][2][3][4][5] . Providing information about health-related behavior is one component, which raises awareness and builds the knowledge base.…”

“…Most health promotion trials at worksites follow a multicomponent intervention approach [1][2][3][4][5] . Providing information about health-related behavior is one component, which raises awareness and builds the knowledge base.…”

“…A multicomponent intervention in a cluster-controlled trial, the HIPOP-OHP study, showed beneficial effects on lipid profiles in a workplace group 7) . They used A3-size posters and stands positioned at a point of choice in the cafeteria to present information about healthy behavior 4,8) . A few message design principles have emerged from other studies.…”

Marital Status and Cardiovascular Risk Factors among Middle‐aged Japanese Male Workers: The High‐risk and Population Strategy for Occupational Health Promotion (HIPOP‐OHP) Study

“…We analyzed baseline data from the high-risk and population strategy for occupational health promotion (HIPOP-OHP) study [18][19][20][21][22][23][24][25][26][27][28] . In brief, HIPOP-OHP was an interventional survey to establish a methodology for improving CVD risk factors at the workplace.…”